The rise of value-based care has led to a greater discussion on the importance of pharmacists in the health system. Recently, a new review by an accountable care organization (ACO) known as Partners for Kids (PFK) has detailed how the inclusion of pharmacists in the development and execution of various quality improvements within the organization…
According to recent studies, it is expected that Medicare’s projected spending will be well over $1.5 trillion by the year 2028- that is more than double what the value was just two years ago! All Medicare asks from ACOs are better patient outcomes. Many ACOs have already reduced costs and thus saved Medicare approximately $1…
Using single diagnostic codes and leveraging “present on admission” designations improved Medicare payment models, predicting total patients costs within 30 days of hospitalization better than the current grouped diagnostic code method, a study published in JAMA Open Network found. Changing the variables currently used by CMS in patient cost prediction models could have serious implications for research, benchmarking public…
The Medicare Shared Savings Program, which governs the majority of Medicare accountable care organizations (ACOs), and Medicare Advantage are gaining in popularity. But the former is saving taxpayers, while the latter is incurring costs, a new report in Health Affairs finds. “Our examination of the literature indicates that Medicare Advantage ‘costs’ Medicare; that is, when a beneficiary joins MA,…
More employers increasingly will drop relationships with payers and instead contract directly with providers through accountable care organizations. Employers will want to work with ACOs with the intent of focusing on the population health of their employees, according to a new study by Frost & Sullivan, a consulting and research firm. The study, entitled Global…
Care coordination by definition is a strategy that is focused on bringing together the multiple parties of a patient’s care team to knock down barriers of communication in order to enable the best outcomes for your patients. However, by doing so, your healthcare organization stands to see significant savings on your bottom line. Here are a few…
The individual entities in any Accountable Care Organization (ACO) are always under the pressure to reduce their costs as well as strengthen their healthcare strategies to improve patient outcomes and maximize the benefits of being a part of the ACO. Thus, they are familiar with the fact that they need to develop strategies for accomplishing…
Last week CMS released a proposed rule addressing revisions in the Physician Fee Schedule (PFS) and the Quality Payment Program (QPP), along with a few other matters. Of 1,704 pages, only about 20 addressed ACOs issues directly. But ACOs should take a holistic approach to reading this proposed rule, as well as the proposed Outpatient Prospective Payment…
Researchers recently sought to better understand how Accountable Care Organization (ACO) participation impacts spending in rural and underserved areas. According to the study results, which are published online in the New England Journal of Medicine, Medicare spending was lower among providers serving in rural and underserved areas who also participated in ACO shared savings contracts. “The Centers…
The medical assistant-only model for primary care staffing may be the most cost-effective for practices relying on fee-for-service revenue, but the model will not be able to support value-based care and other sophisticated revenue arrangements, Premier recently reported. In a new analysis of 2018 data from 257 family medicine and primary care practices, the healthcare improvement…